navigating reimbursed markets in asia-pacific

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Navigating Reimbursed Markets in Asia-PacificAn audio interview with Jan-Willem Eleveld, IMS Vice President, Management Consulting, APAC

AUDIO INTERVIEW!

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Navigating Reimbursed Markets in Asia-PacificIMS Expert: Jan-Willem Eleveld Length: ~11:30 minutes

Jan-Willem Eleveld

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To download the PDF transcript, click here.

Questions? Comments? Fill out the form at the end of this presentation.

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http://www.imshealth.com/deployedfiles/imshealth/Global/Asia%20Pacific/Content/Documents/Reimbursed%20Markets%20Interview%20English%20FINAL%20PDF.pdf

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I guess we should start by clarifying what we mean by reimbursed markets?

Jan-Willem Eleveld (JE): Okay. IMS defines a reimbursed market as a market where access to healthcare is provided by a single payer, usually the government. In these markets, everyone has access to healthcare which is funded through the government. In the Asia-Pacific region, these markets include primarily Korea, Taiwan and Australia.


To download the PDF transcript, click here.

Questions? Comments? Fill out the form at the end of this presentation.

http://goo.gl/MCAtw


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I see. So if there are only three countries in the region that are reimbursed markets, how would IMS define the rest?

JE: Basically, most other countries in Asia are still defined as out of pocket markets, as well as hybrid markets. These markets include some combination of government-funded and privately-funded healthcare. For example, India, Indonesia and the Philippines are Out of Pocket markets while China, Thailand and Malaysia are hybrid markets, with increasing levels of reimbursement for essential drugs.


To download the PDF transcript, click here.Questions? Comments? Fill out the form at the end of this presentation.Know more on IMS Health, click here

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That’s interesting. So can all markets, reimbursed, out of pocket and hybrids be approached the same way?

JE: No, they really cannot, and that has been a common misconception and the reason for so many failed launches in the past. Each market has to be handled differently, and the approach to each market almost customized.



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So each launch has to be handled differently?

JE: Definitely. The launch environment is much harsher today than it was say even three years ago. Our market insights and work with a large variety of clients suggest an updated approach to priorities and new commercial models that are driving launch success in both reimbursed and non-reimbursed, as well as hybrid markets.



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So they need to be handled differently, in what way?

JE: Well, firstly, products have to be on the list of approved medicines for reimbursement or they will find it very hard to compete. To get on this list, the product has to be proven safe and effective, but also must prove its value compared to existing alternatives. In Australia and Korea, for example, proof must be provided upon submission of a company’s application to be listed, including pharmacoeconomics data.



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And is it the same for Taiwan?JE: Taiwan is the same in that a reimbursement price has to be negotiated with the government. However, the process is still less sophisticated and less regulated than in Korea and Australia.

I see. So having gotten on the list, what else should companies consider to increase their competitiveness?JE: It’s not just getting on the list that matters, but also getting the most appropriate reimbursement conditions. We’ve seen how local payers and regulators are playing an ever increasing role in the success or failure of products coming to the market.



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What makes a successful launch?

JE: Well, successful launches are powered by compelling demonstrations of value which are drawn from well-planned trial programs. The failure to strike the right balance between regulatory requirements and payer concerns can undoubtedly hinder a launch. For instance, payers are looking for improvement in overall survival rates for new oncology drugs and will decline reimbursement with less convincing endpoints.



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That’s an interesting point. What do you mean the most appropriate reimbursement conditions?

JE: Companies need to make sure they will get the maximum reimbursement relevant to the approved indication of the drug. In our most current launch analysis of the region, we see how gaining advocacy, approval and market access requires a powerful value proposition that appeals to both payers and regulators.



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How is that achieved?

JE: Well, it increasingly means meeting disparate – and possibly contradictory – needs. A product may get on the reimbursement list for treatment of just one indication even though its efficacy is recognized for multiple indications. Or it may get listed for reimbursement for one year of treatment only, while the patient would need to take the product for many years. So, there is a complex set of options companies need to invest need to work through.



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So success in obtaining the best possible reimbursement can determine the success of the product in the market.

JE: Absolutely. Once reimbursed, it usually supports a faster uptake of the product compared to out-of-pocket markets. In our latest Launch Excellence work, we identified five key drivers of uptake that critically build market share and maximize brand performance.



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OK. Let’s break the down one by one.JE: Well, the first would be achieving brand advocacy among key stakeholders – regulators, payers, key opinion leaders, prescribers and patients with an early focus on creating the right value proposition.

OKJE: The second is gaining brand approval at a regulatory level with optimal positioning and labelling for the right patients.

Right.



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JE: Thirdly they need to secure market access on the right terms with national and sub national payers.The fourth step is to attain brand adoption for the optimal patient segments with a focus on working with prescribers and providers to achieve early strong positioning.

And the fifth?JE: That would be to ensure brand adherence by retaining patients as loyal repeaters for as long as clinically possible.These key drivers in fact are not different in the Asia Pacific reimbursed markets compared to the European markets.



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Yes, I can see that these five elements are basic across all geographies and markets. But coming back again to addressing price issues specifically in relation to non-reimbursed markets, which are fragmented, you have to keep renegotiating your price I suppose.

JE: That’s correct. Mind you, in both markets, you still have to convince doctors to prescribe the products. But at least in reimbursed markets, negotiation on price only has to happen once, so it’s half the battle won.



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JE: APAC is an emerging region so the healthcare landscape is under constant development. It is still a relatively young market, and most countries in the region are on the path to becoming reimbursed markets in some form or another, mostly because of the importance of providing affordable and accessible healthcare for all on each government’s political agenda.

I’m surprised there are only three countries that are reimbursed markets in APAC. Why not more?



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Yes, I suppose that makes sense. So going into the reimbursement markets of Australia, Korea and Taiwan, what should pharmaceutical companies be doing to optimise success in these markets?

JE: Well, as I said before, there is a growing trend for launch success to be more driven by gaining payer acceptance than individual prescriber adoption. Successful launches are powered by demonstrations of value, so companies need to engage stakeholders earlier in the game and before the actual launch of their product. They need to understand the dynamics of each of those individual market where they plan to launch.



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So once the product is on the reimbursement list, is it pretty much guaranteed that the market is secure?

JE: Not at all. And that’s also a crucial point. Once companies have their products on the reimbursed medicines list, they still need to convince healthcare professionals when and where to use the particular product so as to ensure it continues to expand in market share. To do this, they need to explain the science behind the molecule to the physician and patient to familiarize them with the brand and to get them comfortable with prescribing it and taking the drug.



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So building the connection directly with patients is an important strategy?JE: Absolutely. But not just the patients. They need to encourage brand loyalty among doctors, too.

So, on the subject of brand loyalty and defending the brand in the face of competition, am I right in thinking that these three reimbursed markets have strong local generics markets?JE: Yes, they do. Although the majority of the value of each market is still driven by patented or original brands.



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Will that impact the product life cycle of pharmaceuticals on the approved reimbursement list at all?

JE: To a different degree and in different countries, it will. Australia has quite an advanced generics market, so upon patent expiry, the generic products tend to take over. However, in Korea and Taiwan the situation is different. In those markets, generics sell at very high prices, up to 80% of the originals, so there is little price gain between originals and their generic equivalents. The local generics companies have strong profits as they have virtually no research costs involved. As a consequence, there is no real financial incentive for the local industry to change much.



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I see. So how do pharmas compete effectively once patents expire?

JE: They need to decide where their products sit in these markets. Often they can trade off old products to get new ones on the approved list. The danger is for companies to be short-sighted and look only at one particular product. They need to be putting themselves in the buyer’s shoes. Buyers will be looking at the company’s whole portfolio rather than one isolated product, and will make buying decisions on a more macro level.



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So what assistance can pharmas expect from IMS when launching in reimbursed markets?

JE: Well, IMS is well positioned to help MNCs, or multinational pharmaceutical companies, avoid common pitfalls in these markets. We are present in nearly all Asian countries and employ more than 220 consultants – all of whom have deep market experience and can help a company determine how to best optimise their value proposition, and effectively and efficiently engage stakeholders. We also map out resource allocation, and monitor and drive performance, as well as align and prepare these organisations for launch.



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Thank you for listening!

• To download an MP3 of this interview, click here.

• To download the PDF transcript, click here.

• Questions? Comments? − Fill out the form at the bottom of this slide, or − Visit www.imshealth.com or email [email protected].

navigating reimbursed markets in asia-pacific

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